Federal Xxxxxx Life Assurance Company [ZURICH LIFE LOGO HERE]
A Stock Life Insurance Company
0000 XxXxxxxx Xxxxxxx
Xxxxxxxxxx, Xxxxxxxx 00000-0000
RIGHT TO CANCEL - FREE LOOK PROVISION - At any time within 10 days of receiving
this contract You may return it to Us or to the representative through whom it
was purchased. Immediately upon our receipt, this contract will be voided as if
it had never been in force. All Purchase Payments allocated to the Fixed Account
plus the Separate Account contract Value plus Market Adjusted Values computed at
the end of the valuation period following Our receipt of this contract will then
be refunded within 10 days.
We agree to pay an Annuity to the Owner provided this contract is in force on
the Annuity Date.
We further agree to pay the death benefit prior to the Annuity Date when a death
benefit is payable. Payment will be made upon Our receipt of due proof of death
and the return of this contract.
This contract is issued in consideration of the initial Purchase Payment. The
provisions on this cover and the pages that follow are part of this contract.
Signed for Federal Xxxxxx Life Assurance Company at its home office in
Schaumburg, Illinois.
[SIGNATURE LOGO HERE] [SIGNATURE LOGO HERE]
Secretary President
FLEXIBLE PREMIUM MODIFIED GUARANTEED, FIXED AND VARIABLE DEFERRED ANNUITY
CONTRACT
NON-PARTICIPATING
BENEFITS, PAYMENTS AND VALUES PROVIDED BY THE CONTRACT, WHEN BASED ON THE
INVESTMENT EXPERIENCE OF THE SUBACCOUNTS, ARE VARIABLE AND ARE NOT GUARANTEED AS
TO DOLLAR AMOUNT. REFER TO THE VARIABLE ACCOUNT AND ANNUITY PERIOD PROVISIONS
FOR A DETERMINATION OF ANY VARIABLE BENEFITS.
BENEFITS, PAYMENTS AND VALUES PROVIDED BY THE CONTRACT, WHEN BASED ON GUARANTEE
PERIOD VALUES, MAY INCREASE OR DECREASE IN ACCORDANCE WITH THE MARKET VALUE
ADJUSTMENT FORMULA STATED IN THE CONTRACT SCHEDULE.
This a legal contract between the Owner and Federal Xxxxxx Life Assurance
Company
READ YOUR CONTRACT CAREFULLY.
Form No. S-3254
TABLE OF CONTENTS
Page
CONTRACT SCHEDULE Follows Table of Contents
DEFINITIONS 1-3
GENERAL PROVISIONS 3-4
The Entire Contract 3
Modification of Contract 3
Incontestability 3
Change of Annuity Date 3
Assignment 3
Due Proof of Death 3
Reserves, Contract Values and Death Benefits 3
Non-Participating 3
Reports 3
Premium Taxes 4
Creditors 4
OWNER, BENEFICIARY AND ANNUITANT PROVISIONS 4-5
Owner 4
Change of Ownership 4
Beneficiary Designation and Change of Beneficiary 4
Death of Beneficiary 4
Annuitant 5
PURCHASE PAYMENT PROVISIONS 5
Purchase Payment Limitations 5
Place of Payment 5
FIXED ACCOUNT PROVISIONS 5-6
Fixed Account Contract Value 5-6
GUARANTEE PERIOD PROVISIONS 6
Guarantee Period 6
Guarantee Period Value 6
Market Value Adjustment 6
VARIABLE ACCOUNT PROVISIONS 6-7
Separate Account 6
Liabilities of the Separate Account 6
Subaccounts 6
Fund 6
Rights Reserved by the Company 6
Accumulation Unit Value 6
Investment Experience Factor 7
TRANSFER AND WITHDRAWAL PROVISIONS 8-10
Withdrawals During the Accumulation Period 9
Withdrawal Charges 9
Transfers and Withdrawal Procedures 10
Deferment of Withdrawal or Transfer 10
S-3254
TABLE OF CONTENTS
Page
DEATH BENEFIT PROVISIONS 10-11
Amount Payable Upon Death 10
Payment of Death Benefits During the Accumulation Period 11
Spousal Continuation 11
ANNUITY PERIOD PROVISIONS 12-16
Annuity Options 12
Option 1 Certain Period Annuity 12
Option 2 Life Annuity 12
Option 3 Life Annuity with Installments Guaranteed 12
Option 4 Joint and Survivor Annuity 12
Option 5 Joint and Survivor Annuity with Installments Guaranteed 12
Other Options 12
Election of Annuity Option 12
Electing a Fixed or Variable Annuity Option 13
Fixed Annuity 13
Variable Annuity 13
Annuity Unit Value 13
Basis of Annuity Options 13
Withdrawal Charge Upon Annuitization 13
Transfers Between Subaccounts 14
Conversions from a Fixed Annuity Payment 14-15
Conversions to a Fixed Annuity Payment 15
Payment of Death Benefits During the Annuity Period 15
Disbursement Upon Death of Annuitant: Under Options 1, 3 or 5 16
Supplementary Agreement 16
Date of First Payment 16
Evidence of Age, Sex and Survival 16
Misstatement of Age or Sex 16
ANNUITY OPTION TABLE Follows Page 16
ENDORSEMENTS, if any Follow Annuity Option Table
DEFINITIONS ACCUMULATED GUARANTEE PERIOD VALUE - The sum of the Guarantee
Period Values.
ACCUMULATION PERIOD - The period between the Issue Date and the
Annuity Date.
ACCUMULATION UNIT - An accounting unit of measure used to
calculate the value of each Subaccount.
ADMINISTRATION CHARGE - A charge deducted in the calculation of
the Accumulation Unit value and the Annuity Unit value for a
portion of Our administrative costs.
AGE - The attained age.
ANNIVERSARY VALUE - The Contract Value calculated on each
contract Anniversary during the Accumulation Period.
ANNUITANT - The person during whose lifetime the Annuity is to be
paid. Joint Annuitants may be named under Non-qualified Plans and
any reference to Annuitant shall include Joint Annuitants.
ANNUITY - A series of payments paid in accordance with this
contract which begin on the Annuity Date.
ANNUITY DATE - The date on which Annuity payments begin.
ANNUITY PERIOD - The period that starts on the Annuity Date.
ANNUITY UNIT - An accounting unit of measure used to calculate
the amount of Variable Annuity payments after the first Annuity
payment.
CONTRACT ANNIVERSARY - An anniversary of the Issue Date
CONTRACT OWNER, OR OWNER - See "You, Your, Yours" below
CONTRACT VALUE - The sum of the Fixed Account Contract Value plus
the Separate Account Contract Value plus the Accumulated
Guarantee Period Value.
CONTRACT YEAR - A one year period starting on the Issue Date and
successive Contract Anniversaries.
DEBT - The principal of any outstanding loan plus any accrued
interest. Loans are available under certain Qualified Plans.
FIXED ACCOUNT - The General Account of FKLA to which an Owner may
allocate all or a portion of Purchase Payments or Contract Value.
FIXED ACCOUNT CONTRACT VALUE - The value of amounts allocated
under the contract to the Fixed Account.
FIXED ANNUITY - An Annuity payment plan that does not vary as to
dollar amount.
FREE WITHDRAWAL ALLOWANCE - Amount of Contract Value that may be
withdrawn each Contract Year without incurring a withdrawal
charge as described in the Contract Schedule.
FUND - An investment company or separate series thereof, in which
the Subaccounts of the Separate Account invest.
GENERAL ACCOUNT - Our assets other than those allocated to the
Separate Account, the non-unitized Separate Account or any other
Separate Account.
Page 1
Page 2
DEFINITIONS (continued)
GUARANTEE PERIOD - A period of time during which an amount is to
be credited with a guaranteed interest rate, subject to a Market
Value Adjustment prior to the end of the Guarantee Period. The
Guarantee Periods initially offered are stated in the Contract
Schedule.
GUARANTEE PERIOD VALUE - The (1) Purchase Payments allocated or
amounts transferred to a Guarantee Period; plus (2) interest
credited; minus (3) withdrawals, previously assessed withdrawal
charges and transfers; adjusted for (4) any applicable Market
Value Adjustment previously made.
ISSUE DATE - The Issue Date stated in the Contract Schedule.
MARKET ADJUSTED VALUE - A Guarantee Period Value adjusted by the
Market Value Adjustment formula prior to the end of a Guarantee
Period.
MARKET VALUE ADJUSTMENT - An adjustment of Guarantee Period
Values in accordance with the Market Value Adjustment formula
prior to the end of the Guarantee Period. The adjustment reflects
the change in the value of the Guarantee Period Value due to
changes in interest rates since the date the Guarantee Period
commenced. The Market Value Adjustment formula is stated in the
Contract Schedule.
MORTALITY AND EXPENSE RISK CHARGE - A charge deducted in the
calculation of the Accumulation Unit value and the Annuity Unit
value. It is for Our assumption of mortality risks and expense
guarantees. This charge is shown in the Contract Schedule.
NONQUALIFED PLAN - This contract issued other than as a Qualified
Plan.
PURCHASE PAYMENTS - The dollar amount We receive in U.S. currency
to buy the benefits this contract provides.
QUALIFIED PLAN - A contract issued under a retirement plan which
qualifies for favorable income tax treatment under Section 401,
403, 408, 408A, or 457 of the Internal Revenue Code as amended.
If this contract is issued under a Qualified Plan additional
provisions may apply. The rider or amendment to this contract
used to qualify it under the applicable section of the Internal
Revenue Code will indicate the extent of change in the
provisions.
RECORDS MAINTENANCE CHARGE - A charge assessed against Your
contract as specified in the Contract Schedule.
SEPARATE ACCOUNT - A unit investment trust registered with the
Securities and Exchange Commission under the Investment Company
Act of 1940 and identified in the Contract Schedule.
SEPARATE ACCOUNT CONTRACT VALUE - The sum of the Subaccount
Values of this contract on a Valuation Date.
SUBACCOUNTS - The subdivisions of the Separate Account, the
assets of which consist solely of shares of the corresponding
Fund.
SUBACCOUNT VALUE - The value of Your interest in each Subaccount.
VALUATION DATE - Each business day that applicable law requires
that We value the assets of the Separate Account. Currently this
is each day that the New York Stock Exchange is open for trading.
VALUATION PERIOD - The period that starts at the close of a
Valuation Date and ends at the close of the next succeeding
Valuation Date.
DEFINITIONS (continued)
VARIABLE ANNUITY - An Annuity payment plan which varies as to dollar amount
because of Subaccount investment experience.
WE, OUR, US - Federal Xxxxxx Life Assurance Company, Schaumburg, Illinois.
YOU, YOUR, YOURS - The party(s) named as Owner unless later changed as provided
in this contract. Under a Nonqualified Plan when more than one person is named
as Owner, the terms "You,""Your,""Yours," means joint Owners.
GENERAL PROVISIONS
The Entire Contract
This contract, any written application attached to this contract, and any
endorsements and riders constitute the entire contract between the parties.
Modification of Contract
Only Our president, secretary and assistant secretaries have the power to
approve a change or waive any provisions of this contract. Any such
modifications must be in writing. No agent or person other than the officers
named has the authority to change or waive the provisions of this contract.
Upon notice to You, this contract may be modified by Us as is necessary to
comply with any law or regulation issued by a governmental agency to which We or
the Separate Account is subject or as is necessary to assure continued
qualification of this contract under the Internal Revenue Code or other laws
relating to retirement plans or annuities or as otherwise may be in Your best
interest. In the event of a modification, We may make appropriate endorsement to
this contract and We will obtain all required regulatory approvals.
Incontestability
We cannot contest this contract after it has been in force for two years from
the Issue Date.
Change of Annuity Date
You may write to Us prior to the death of an Owner and the Annuity Date and
request a change of the Annuity Date. The new Annuity Date must not be earlier
than the minimum Annuity Date or beyond the maximum Annuity Date stated in the
contract Schedule.
Assignment
No assignment under this contract is binding unless We receive it in writing. We
assume no responsibility for the validity or sufficiency of any assignment. The
rights of the Owner and beneficiary are subject to the assignment. Any claim is
subject to proof of interest of the assignee.
Due Proof of Death
We must receive written proof of the Owner's death in the form of a certified
death certificate when a death benefit is payable.
Date of Due Proof
The Valuation Date We receive Due Proof of Death.
Reserves, Contract Values and Death Benefits
All reserves are equal to or greater than those required by statute. Any
available Contract Value, paid up annuity benefit and death benefit are not less
than the minimum benefits required by the statutes of the state in which the
contract is delivered.
Non-Participating
This contract does not pay dividends. It will not share in Our surplus or
earnings.
Reports
At least once each Contract Year We will send You a statement showing Purchase
Payments received, interest credited, investment experience, and charges made
since the last report, as well as any other information required by statute.
Page 3
GENERAL PROVISIONS (continued)
Premium Taxes
We will make a deduction for state premium taxes in certain situations. On any
contract subject to premium tax, as provided under applicable law, the tax will
be deducted from: a. the Purchase Payments when We receive them; b. the Contract
Value upon total withdrawal; or c. from the total contract Value applied to any
Annuity option at the time Annuity payments start. In no event will an amount be
deducted for premium taxes before the Company has incurred a tax liability under
applicable state law.
Creditors
The proceeds of this contract and any payment under an Annuity option will be
exempt from the claims of creditors and from legal process to the extent
permitted by law.
OWNER, BENEFICIARY AND ANNUITANT PROVISIONS
Owner
Before the Annuity Date and prior to the death of an Owner, You may exercise
every option and right conferred by this contract including the right of
assignment. The joint Owners must agree to the exercise of any option or right
if more than one Owner is named.
Change of Ownership
You may change the Owner by written request before the Annuity Date and prior to
the death of an Owner. You must furnish information sufficient to clearly
identify the new Owner to Us. The change is subject to any existing assignment
of this contract. After We receive the change, it will take effect on the date
the written notice is signed. However, any action taken by Us before the change
is recorded by Us remains in effect. Any change is subject to the payment of any
proceeds. We may require You to return this contract to Us for endorsement of a
change.
Beneficiary Designation and Change of Beneficiary
The beneficiary initially designated is shown in the Contract Schedule. In the
case of joint owners, the surviving joint Owner is automatically the primary
beneficiary of any death benefit resulting from the death of a joint Owner. You
may change the beneficiary if You send Us written notice in a form acceptable to
Us. Changes are subject to the following conditions:
1. Prior to the Annuity Date the change must be filed while You are alive;
2. After the Annuity Date the change must be filed while You and the
Annuitant(s) are alive;
3. This contract must be in force at the time You file a change;
4. Such change must not be prohibited by the terms of an existing assignment,
beneficiary designation or other restriction;
5. After We receive the change, it will take effect on the date the written
notice was signed. However, any action taken by Us before the change form
is recorded by Us will remain in effect;
6. The request for change must provide information sufficient to identify the
new beneficiary; and
7. In the case of joint Owners, the designation of a beneficiary(ies) other
than the surviving joint Owner will be deemed to be a contingent
beneficiary(ies).
We may require You to return this contract to Us for endorsement of a change.
Death of Beneficiary
The interest of a beneficiary who dies before the distribution of the death
benefit will pass to the other beneficiaries, if any, share and share alike,
unless otherwise provided in the beneficiary designation. If no beneficiary
survives or is named, the distribution will be made to Your estate when the You
die.
Page 4
OWNER, BENEFICIARY AND ANNUITANT PROVISIONS (continued)
Annuitant
The Annuitant is shown in the Contract Schedule. Prior to the Annuity Date, an
Annuitant may be replaced or added unless the Owner is a non-natural person. At
all times there must be at least one Annuitant. If the Annuitant dies, the
youngest Owner will become the new Annuitant unless a new Annuitant is otherwise
named. Upon the death of an Annuitant prior to the Annuity Date, a death benefit
is not paid unless the Owner is a non-natural person.
Any subsequent Annuitant must not have attained Age 81 prior to the Issue Date.
PURCHASE PAYMENT PROVISIONS
Purchase Payment Limitations
The minimum initial purchase payment, subsequent purchase payment, maximum
purchase payment date, and maximum total purchase payment limits are shown in
the Contract Schedule.
The minimum initial allocation or transfer to a Guarantee Period, Fixed Account,
or to a Subaccount is shown in the Contract Schedule.
The sum of all Purchase Payments allocated to the contract may not exceed the
maximum total Purchase Payments shown in the Contract Schedule.
The sum of all Purchase Payments allocated to the Fixed Account in any Contract
Year may not exceed the maximum fixed account purchase payments shown in the
Contract Schedule. Purchase Payments made under a systematic investment program
that has been approved by Us are not subject to this limitation. We reserve the
right to modify or terminate this provision and to apply the Fixed Account
allocation limitation to all Purchase Payments.
We reserve the right: (a) not to allow allocation of any Purchase Payment to the
Fixed Account if the Fixed Account interest rate applicable to that Purchase
Payment would be less than or equal to 3%; and, (b) to except Purchase Payments
that are part of a systematic investment program that has been approved by Us
from such allocation limitation.
We reserve the right to waive these limits. We also reserve the right not to
accept any Purchase Payment.
Purchase Payment Bonus
Subject to the limitation shown below, Purchase Payments will be increased by
the purchase payments bonus shown on the Contract Schedule before being
allocated to the various account of this contract.
We reserve the right to not increase a Purchase Payment by the purchase payment
bonus if at the time the Purchase Payment is made the sum of partial withdrawals
and loans made under this contract exceeds the sum of Purchase Payments and loan
repayments.
Place of Payment
All Purchase Payments under this contract must be paid to Us at Our home office
or such other location as We may select. We will notify You and any other
interested parties in writing of such other locations. Purchase Payments
received by an agent will not be considered received by Us.
FIXED ACCOUNT PROVISIONS
Fixed Account Contract Value
The Fixed Account Contract Value includes:
1. Your Purchase Payments allocated to the Fixed Account; plus
2. amounts transferred to the Fixed Account; plus
3. interest credited; minus
4. withdrawals, previously assessed withdrawal charges and transfers from the
Fixed Account, minus
5. any applicable portion of the Records Maintenance Charge.
The initial fixed account interest rate credited to the initial purchase payment
is shown in the Contract Schedule and is in effect through the period also shown
in the Contract Schedule. We will declare the Fixed Account interest rate
applicable to the initial purchase payment for each subsequent interest rate
period at the beginning of each subsequent interest rate period shown in the
Contract Schedule.
Page 5
FIXED ACCOUNT PROVISIONS (continued)
We will declare the Fixed Account interest rate with respect to each subsequent
Purchase Payment or transfer received. Any such Purchase Payment or transfer We
receive will be credited that rate through the end of the interest rate period
shown in the Contract Schedule. We will declare the Fixed Account interest rate
applicable to each subsequent Purchase Payment or transfer for each subsequent
interest rate period at the beginning of each subsequent interest rate period.
We reserve the right to declare the Fixed Account current interest rate(s) based
upon the Issue Date, the date We receive a Purchase Payment or the date of
account transfer.
We calculate the interest credited to the Fixed Account by compounding daily, at
daily interest rates, rates that would produce at the end of 12 months a result
identical to the one produced by applying an annual interest rate.
The minimum guaranteed Fixed Account interest rate is shown in the Contract
Schedule.
GUARANTEE PERIOD PROVISIONS
Guarantee Period
We hold all amounts allocated to a Guarantee Period in a non-unitized Separate
Account. The non-unitized Separate Account may also hold amounts from other
contracts and certificates we issue. The assets of this Separate Account equal
to the reserves and other liabilities of this Separate Account will not be
charged with liabilities arising out of any other business We may conduct. The
initial Guarantee Periods available under this contract are shown in the
Contract Schedule.
Guarantee Period Value
On any Valuation Date, the Guarantee Period Value includes:
1. Your Purchase Payments allocated to the Guarantee Period; plus
2. amounts transferred to the Guarantee Period; plus
3. interest credited; minus
4. withdrawals, previously assessed withdrawal charges and transfers from the
Guarantee Period; minus
5. any applicable portion of the Records Maintenance Charge; adjusted for
6. any applicable Market Value Adjustment previously made.
The Guarantee Period(s) initially elected and the interest rate(s) initially
credited are shown in the Contract Schedule. The initial interest rate credited
to subsequent Purchase Payments or transfers will be declared at the time the
payment or transfer is received. At the end of a Guarantee Period, We will
declare a guaranteed interest rate applicable for the next subsequent Guarantee
Period.
We calculate the interest credited to the Guarantee Period Value by compounding
daily, at daily interest rates, rates which would produce at the end of 12
months a result identical to the one produced by applying an annual interest
rate.
Market Value Adjustment
The Market Value Adjustment formula is stated in the Contract Schedule. This
formula is applicable for both an upward and downward adjustment to a Guarantee
Period Value when, prior to the end of a Guarantee Period, such value is:
1. taken as a total or partial withdrawal;
2. applied to purchase an Annuity option; or
3. transferred to another Guarantee Period, the Fixed Account, or a
Subaccount.
However, a Market Value Adjustment will not be applied to any Guarantee Period
Value transaction effected within 30 days after the end of the applicable
Guarantee Period.
Page 6
VARIABLE ACCOUNT PROVISIONS
Separate Account
The variable benefits under this contract are provided through the Separate
Account identified in the Contract Schedule. The Separate Account is registered
with the Securities and Exchange Commission as a unit investment trust under the
Investment Company Act of 1940. It is a separate investment account maintained
by Us into which a portion of Our assets has been allocated for this contract
and may be allocated for certain other contracts and certificates We issue.
Liabilities of the Separate Account
The assets equal to the reserves and other liabilities of the Separate Account
will not be charged with liabilities arising out of any other business We may
conduct. We will value the assets of the Separate Account on each Valuation
Date.
Subaccounts
The Separate Account consists of multiple Subaccounts. We may from time to time,
combine or remove Subaccounts in the Separate Account and establish additional
Subaccounts of the Separate Account. In such event, We may permit You to select
other Subaccounts under the contract. However, the right to select any other
Subaccount is limited by the terms and conditions We may impose on such
transactions.
Fund
Each Subaccount of the Separate Account will buy shares of a Fund or a separate
series of a Fund. Each Fund is registered under the Investment Company Act of
1940 as an open-end diversified management investment company. Each series of a
Fund represents a separate investment portfolio that corresponds to one of the
Subaccounts of the Separate Account.
If We establish additional Subaccounts, each new Subaccount will invest in a new
series of a Fund or in shares of another investment company. We may also
substitute other investment companies.
Rights Reserved by the Company
We reserve the right, subject to compliance with the current law or as it may be
changed in the future:
1. To operate the Separate Account in any form permitted under the Investment
Company Act of 1940 or in any other form permitted by law;
2. To take any action necessary to comply with or obtain and continue any
exemptions from the Investment Company Act of 1940 or to comply with any
other applicable law;
3. To transfer any assets in any Subaccount to another Subaccount or to one or
more Separate Accounts, or the General Account, or to add, combine or
remove Subaccounts in the Separate Account;
4. To delete the shares of any of the portfolios of a Fund or any other
open-end investment company and to substitute, for the Fund shares held in
any Subaccount, the shares of another portfolio of a Fund or the shares of
another investment company or any other investment permitted by law; and
5. To change the way We assess charges, but not to increase the aggregate
amount above that currently charged to the Separate Account and the Funds
in connection with this contract.
When required by law, We will obtain Your approval of such changes and the
approval of any regulatory authority.
Accumulation Unit Value
Each Subaccount has an Accumulation Unit value for each combination of charges.
When Purchase Payments or other amounts are allocated to a Subaccount, a number
of units are purchased based on the relevant Accumulation Unit value of the
Subaccount at the end of the Valuation Period during which the allocation is
made. When amounts are transferred out of or deducted from a Subaccount, units
are redeemed in a similar manner. The value of a Subaccount on any Valuation
Date is the number of units held in the Subaccount times the relevant
Accumulation Unit value on that Valuation Date.
An Accumulation Unit value for each subsequent Valuation Period is the relevant
investment experience factor for that period multiplied by the Accumulation Unit
value for the period immediately preceding. The Accumulation Unit values for
each Valuation Period are applied to each day in a Valuation Period. The number
of Accumulation Units will not change as a result of investment experience;
however, adding, deleting or modifying a rider for this contract will result in
a change in the number of Accumulation Units.
Page 7
VARIABLE ACCOUNT PROVISIONS (continued)
Investment Experience Factor
Each Subaccount has an investment experience factor for each combination of
charges. The investment experience factor of a Subaccount for a combination of
charges for a Valuation Period is determined by dividing 1. by 2. and
subtracting 3. from the result, where:
1. is the net result of:
a. the net asset value per share of the investment held in the Subaccount
determined at the end of the current Valuation Period; plus
b. the per share amount of any dividend or capital gain distributions
made by the investments held in the Subaccount, if the "ex-dividend"
date occurs during the current Valuation Period; plus or minus
c. a credit or charge for any taxes reserved for the current Valuation
Period which We determine resulted from the investment operations of
the Subaccount; 2. the net asset value per share of the investment
held in the Subaccount, determined at the end of the last Valuation
Period;
2. the net asset value per share of the investment held in the subaccount,
determined at the end of the next valuation period.
3. is the factor representing the sum of the Separate Account charges
currently applicable for the number of days in the Valuation Period.
TRANSFER AND WITHDRAWAL PROVISION
General Transfer Provision
Any transfer request must clearly specify:
1. the amount which is to be transferred; and
2. the names of the accounts which are affected.
We reserve the right at any time and without notice to any party, to terminate,
suspend, or modify the following transfer provision.
Transfers of separate account and Guarantee Period Contract Value are subject to
the following conditions:
1. The minimum amount which may be transferred, is the Minimum Subsequent
Account Allocation stated in the Contract Schedule or, if smaller the
remaining value of the subaccount. The minimum guaranteed period transfer
amount that may be transferred out of or into a Guaranteed Period is shown
on the Contract Schedule. This amount is also the minimum that must remain
after a transfer.
2. No partial transfer will be made if the remaining value of the Subaccount
or Guarantee Period will be less than the Minimum Initial Account
Allocation stated on the Contract Schedule.
3. No transfer may be made within seven calendar days of the date on which the
first Annuity payment is due.
4. We reserve the right to impose a 15 calendar day waiting period between
transfers for any transfer in excess of 12 in a Contract Year.
5. For the Guarantee Period units, We will transfer Purchase Payments and all
related accumulation received in a given Contract Year, in the
chronological order We receive them.
6. Total transfers into the Fixed Account that would be credited a current
interest rate of 3% or less in any Contract Year may not exceed 25% of the
Contract Value as of: (a) the prior Contract Anniversary; (b) the issue
date for transfers made prior to the First Contract Anniversary. Transfers
made under an asset allocation program that has been approved by Us are not
subject to this limitation but We reserve the right to modify or terminate
this provision and apply the above limitation to such transfers.
7. We reserve the right: (a) not to allow any transfer into the Fixed Account
if the Fixed Account interest rate with respect to that transfer would be
less than or equal to 3% and, (b) to except from such transfer limitation
transfers made under an asset allocation program approved by Us.
Page 8
TRANSFER AND WITHDRAWAL PROVISIONS (continued)
Transfers of Fixed Account Contract Value is subject to the following
conditions:
1. The minimum amount which may be transferred, is the minimum subsequent
account allocation stated on the Contract Schedule or, if smaller, the
remaining value of the Fixed Account.
2. Total transfers out of the Fixed Account in any Contract Year may not
exceed 25% of the value of the fixed account as of: (a) the prior Contract
Anniversary; or (b) the Issue Date for transfers made prior to the first
Contract Anniversary. The entire Fixed Account Contract Value may be
transferred if the transfer out of the Fixed Account would result in a
Fixed Account value less than $5,000. Transfers made under an asset
allocation program that has been approved by Us are not subject to this
limitation but we reserve the right to modify or terminate this provision
and apply the above limitation to such transfers.
3. No transfer may be made within seven calendar days of the date on which the
first Annuity payment is due.
4. We will transfer Purchase Payments and all related accumulation received in
a given Contract Year, in the chronological order We receive them.
Withdrawals During the Accumulation Period
During the Accumulation Period, You may withdraw all or part of the Contract
Value reduced by any withdrawal charge, Debt and applicable premium taxes, and
adjusted by any applicable Market Value Adjustment.
Withdrawals are subject to all of the following conditions:
1. You must return this contract to Us if You elect a total withdrawal.
2. Each withdrawal must be at least $500 or the value that remains in the
Fixed Account or Subaccount if smaller. The minimum withdrawal out of a
Guaranteed Period is $5,000 or the value of the Guaranteed Period if
smaller.
3. The Minimum Subsequent Account Allocation stated in the Contract Schedule
must remain in the account after You make a withdrawal unless the account
is eliminated by such withdrawal.
4. We must receive a written request that indicates the amount of the
withdrawal from the Fixed Account and each Subaccount and Guarantee Period.
5. Withdrawals will reduce each investment option on a proportional basis
unless You direct Us otherwise.
6. Withdrawals will first reduce Your Purchase Payments in the chronological
order in which they were received and then reduce any earnings.
7. If a partial withdrawal would reduce the Contract Value to less than the
minimum contract value after a partial withdrawal stated in the Contract
Schedule, the partial withdrawal will be processed as a total withdrawal.
Page 9
TRANSFER AND WITHDRAWAL PROVISIONS (continued)
Withdrawal Charges
1. All Purchase Payments in a given Contract Year and all related
accumulations are totaled by account and each total is used separately in
computing the withdrawal charge as stated in the withdrawal charge table
shown in the Contract Schedule.
2. All amounts to be withdrawn and any applicable withdrawal charges will be
charged first against Purchase Payments and all related accumulations in
the chronological order We received such Purchase Payments by Contract
Year.
3. Any amount withdrawn that is not subject to a withdrawal charge will be
considered a partial free withdrawal.
4. In the event of a partial withdrawal, a partial free withdrawal is applied
against Purchase Payments and all related accumulations in the
chronological order We received such Purchase Payments by Contract Year
even though the Purchase Payment and related accumulations are no longer
subject to a withdrawal charge.
Transfer and Withdrawal Procedures
We will withdraw or transfer from the Fixed Account or Guarantee Periods as of
the Valuation Date that follows the date We receive the Owner's written or
telephone transfer request. To process a withdrawal, the request must contain
all required information.
We will redeem the necessary number of Accumulation Units to achieve the dollar
amount when the withdrawal or transfer is made from a Subaccount. We will reduce
the number of Accumulation Units credited in each Subaccount by the number of
Accumulation Units redeemed. The reduction in the number of Accumulation Units
is determined based on the Accumulation Unit value at the end of the Valuation
Period when We receive the request, provided the request contains all required
information. We will pay the withdrawal amount within seven calendar days after
the date We receive the request, except as provided below.
Deferment of Withdrawal or Transfer
If the withdrawal or transfer is to be made from a Subaccount, We may suspend
the right of withdrawal or transfer or delay payment more than seven calendar
days:
1. during any period when the New York Stock Exchange is closed other than
customary weekend and holiday closings;
2. when trading in the markets normally utilized is restricted, or an
emergency exists as determined by the Securities and Exchange Commission,
so that disposal of investments or determination of the Accumulation Unit
value is not practical; or
3. for such other periods as the Securities and Exchange Commission by order
may permit for protection of Owners.
We may defer the payment of a withdrawal or transfer from the Fixed Account or
Guarantee Periods, for the period permitted by law. This can never be more than
six months after the Owner sends Us a written request. During the period of
deferral, We will continue to credit interest, at the then current interest
rate(s), to the Fixed Account Contract Value and/or each Guarantee Period Value.
DEATH BENEFIT PROVISIONS
Amount Payable Upon Death
We compute the death benefit at the end of the valuation period following: Our
receipt of due proof of death; such other information We may require to process
the death benefit, and the return of this contract.
If death occurs prior to the oldest Owner age 75, We will pay the greater of the
following less debt:
(a) adjusted contract value; or
(b) adjusted purchase payments
If death occurs after the oldest Owner's age 75, We will pay adjusted contract
value.
Adjusted Contract Value
Adjusted contract value is the Contract Value as of the date of due proof,
increased for any positive Market Value Adjustments.
Page 10
DEATH BENEFIT PROVISIONS (continued)
Adjusted Purchase Payments
Adjusted Purchase Payments is defined as the Purchase Payments, decreased by
premium taxes on Purchase Payments, adjusted proportionately for withdrawals.
Adjustment for Withdrawals
The adjustments for withdrawals is a dollar amount determined for each
withdrawal which is equal to (1) divided by (2) with the result multiplied by
(3), where:
1. is the withdrawal including withdrawal charges;
2. is the Contract Value immediately prior to the withdrawal; and
3. is the value of purchase payments adjusted for prior withdrawals.
Payment of Death Benefits During the Accumulation Period
A death benefit will be paid to the beneficiary upon the death of the Owner, or
a joint Owner, during the Accumulation Period. If the Contract Owner is a
non-natural person, a death benefit will be paid to the beneficiary upon the
death of an Annuitant prior to the Annuity Date.
We will pay the death benefit to the beneficiary after We receive due proof of
death. We will then have no further obligation under this contract.
The entire interest in this contract must be distributed within five years from
the date of death unless it is applied under an Annuity option or the spouse
continues this contract as described below.
The beneficiary may elect to have the death benefit distributed as stated in
Annuity Period Provisions Option 1 provided the beneficiary's life expectancy is
not less than 10 years; or Options 2 or 3 as described in the Annuity Period
Provisions of this contract, based on the life expectancy of the beneficiary as
prescribed by federal regulations unless You have restricted the right to make
such an election. The beneficiary must make this choice within sixty days of the
time We receive due proof of death, and distributions must commence within one
year of the date of death.
If the beneficiary is a non-natural person, the beneficiary must elect that the
entire death benefit be distributed within five years of the date of death.
Spousal Continuation
If this contract was issued as a Nonqualified Plan or an Individual Retirement
Annuity ("IRA") and Your spouse is the primary beneficiary when You die, Your
spouse may elect to be the successor Owner of this contract. This is known as a
Spousal Continuation. In such a case, no death benefit will be payable upon Your
death.
Upon Your death, Your surviving spouse may continue this contract thereby
waiving claim to the death benefit otherwise payable. Electing to continue this
contract under the Spousal Continuation provision of this contract will affect
how the charges and benefits under this contract.
A spousal continuation has the following impact on this contract:
A. The Contract Value will be adjusted to equal the amount of the death benefit.
If the death benefit otherwise payable exceeds the Contract Value one day prior
to the date of continuance, such excess will be credited to the money market
subaccount listed in the Contract Schedule. This amount may subsequently be
transferred from the money market Subaccount to other options under this
contract.
B. After the spousal continuation, the death benefit payable will be determined
as if: (1) this contract was issued on the date of continuance; (2) the Contract
Value applied on this date of continuance resulted from our receipt of an
initial Purchase Payment,
X. Xxxxxxxxxx charges will not apply to withdrawals made from the Contract Value
credited on the date of continuance. Withdrawal Charges will apply to Purchase
Payments made after the date of continuance.
D. This contract may not be continued under a subsequent Spousal Continuation.
We may make certain riders available to the surviving spouse at the time of
continuance.
Page 11
Page 12
ANNUITY PERIOD PROVISIONS
Annuity Options
You may annuitize this contract under one of the following Annuity options:
Option 1
Certain Period Annuity
We will make monthly payments for 10 years.
Option 2
Life Annuity
We will make monthly payments while the Annuitant is alive.
Option 3
Life Annuity with Installments Guaranteed
We will make monthly payments for a 10-year certain period and thereafter while
the Annuitant is alive.
Option 4
Joint and Survivor Annuity
We will pay the full monthly income while both Annuitant(s) are alive. Upon the
death of either Xxxxxxxxx, We will continue to pay a percentage of the original
monthly payment. The percentage payable must be selected at the time the Annuity
option is chosen. The percentages available are 50%, 66 2/3%, 75% and 100%.
Option 5
Joint and Survivor Annuity with Installments Guaranteed
We will make monthly payments for a 10 year certain period and thereafter while
the Annuitants are alive.
Other Options
We may make other Annuity options available.
Election of Annuity Option
We must receive an election of an Annuity option in writing. You may make an
election on or before the Annuity Date provided the Annuitant is alive.
A subsequent change of beneficiary, or an assignment of this contract will
revoke an election unless the assignment provides otherwise.
Upon election of an Annuity option, We agree to pay the Owner on the payment due
dates as stated in the specifications page of the supplementary agreement. The
Owner may direct Us, in writing, to make payments to another person. An option
cannot be changed after the first Annuity payment is made. If the total Contract
Value is applied under one of the Annuity options, this contract must be
surrendered to Us.
If an Annuity option is not elected by the Annuity Date, an Annuity will be paid
under Option 3 if there is one Annuitant on the Annuity Date and Option 5 if
there are joint Annuitants on the Annuity Date.
Electing a Fixed or Variable Annuity Option
You may elect a Fixed Annuity, a Variable Annuity or a combination of both. The
portion of the Contract Value You elect to be paid as a Fixed Annuity, if any,
will be transferred to Our General Account. We must receive your Fixed and
Variable allocation election in writing at least seven days prior to the Annuity
Date. If We do not receive notification from You, all the Contract Value will be
paid to You as a Fixed Annuity.
If your allocation includes a Variable Annuity payment, payments will reflect
the investment performance of the Subaccounts in accordance with the allocation
on the Annuity Date. Allocations will not be changed thereafter, except as
provided in the Transfers Between Subaccounts section.
Payments for all options are derived from the applicable tables. Current Annuity
rates will be used if they produce greater payments than those quoted in the
contract. The age in the tables is the Age of the Annuitant on the last birthday
before the first payment is due.
The option selected must result in a payment that is at least equal to Our
minimum payment, according to Our rules, at the time the Annuity option is
chosen. If at any time the payment is less than the minimum payment, We have the
right to increase the period between payments to quarterly, semi-annual or
annual so that the payment is at least equal to the minimum payment or to make
payment in one lump sum.
ANNUITY PERIOD PROVISIONS (continued)
Xxxxx Xxxxxxx
The portion of the Contract Value You elected to have paid to you as a Fixed
Annuity less any withdrawal charge, charges for other benefits, and Records
Maintenance Charge will be used to determine the Fixed Annuity monthly payment
in accordance with the Annuity option selected. Any Accumulated Guarantee Period
Values will be adjusted for any applicable Market Value Adjustment as well.
Variable Annuity
The portion of the Contract Value You elect to have paid to you as a Variable
Annuity is first reduced by any withdrawal charge, charges for other benefits,
and Records Maintenance Charge. The value that remains is used to determine the
first monthly Annuity payment. The first monthly Annuity payment is based on the
guaranteed Annuity option shown in the Annuity Option Table.
The dollar amount of subsequent payments may increase or decrease depending on
the investment experience of each Subaccount to which Contract Value is
allocated. You may not have more than three Subaccounts at one time. The number
of Annuity Units per payment will remain fixed for each Subaccount unless a
transfer is made. If a transfer is made, the number of Annuity Units per payment
will change. Some Annuity options provide for a reduction in the income level
upon the death of an Annuitant, which will reduce the number of Annuity units.
The number of Annuity Units for each Subaccount is calculated by dividing a. by
b. where:
a. is the amount of the monthly payment that can be attributed to that
Xxxxxxxxxx; and
b. is the Annuity Unit value for that Subaccount at the end of the Valuation
Period.
The Valuation Period includes the date on which the payment is made.
Monthly Annuity payments, after the first payment, are calculated by summing up,
for each Subaccount, the product of a. multiplied by b. where:
a. is the number of Annuity Units per payment in each Subaccount; and
b. is the Annuity Unit value for that Subaccount at the end of the Valuation
Period.
Annuity Unit Value
The Valuation Period includes the date on which the payment is made. The value
of an Annuity Unit for each Subaccount at the end of any Valuation Period is
determined by the result of a. multiplied by b. by c. where:
a. is the Annuity Unit value for the immediately preceding Valuation Period;
and
b. is the net investment experience factor for the Valuation Period for which
the Annuity Unit value is being calculated; and
c. is the interest factor of .99993235 per calendar day of such subsequent
Valuation Period to offset the effect of the assumed rate of 2.50% per year
used in the Annuity Option Table. A different interest rate factor will be
used if an assumed rate other than 2.50% is used in the Annuity Option
Table.
Basis of Annuity Options
The guaranteed monthly payments are based on an interest rate of 2.50% per year
and, where mortality is involved, the "Annuity 2000 Table" developed by the
Society of Actuaries projected using Scale G to the year 2015. We may also make
available Variable Annuity payment options based on assumed investment rates
other than 2.50%, but not greater than 5.00%.
Withdrawal Charge Upon Annuitization
Upon annuitization, a withdrawal charge will be applied as shown in the Contract
Schedule after application of any applicable Market Value Adjustment. The
withdrawal charge is waived when the Owner elects an Annuity option which
provides either an income benefit period of ten years or more or a benefit under
which payment is contingent on the life of the Annuitant(s).
Page 13
ANNUITY PERIOD PROVISIONS (continued)
Transfers Between Subaccounts
During the Annuity Period, You may make transfers between Subaccounts subject to
the following:
1. You must send Us written notice in a form satisfactory to Us.
2. Transfers between Subaccounts are prohibited during the first year of the
Annuity Period; subsequent transfers are limited to one per year.
3. You may not have more than three Subaccounts at any time.
4. At least $5,000 of Annuity Unit value must be transferred from a
Subaccount, unless the transfer will eliminate Your interest in the
Subaccount.
5. At least $5,000 of Annuity Unit value must remain in the Subaccount after a
transfer, unless the transfer will eliminate Your interest in the
Subaccount.
6. If We receive notice of a transfer between Subaccounts more than seven (7)
days before an Annuity payment date, the transfer is effective during the
Valuation Period after the date We receive the notice.
7. If We receive notice of a transfer between Subaccounts less than seven (7)
days before an Annuity Payment date, the transfer is effective during the
Valuation Period after the Annuity Payment date.
We reserve the right at any time and without notice to any party to terminate,
suspend or modify these transfer privileges.
When a transfer is made between Subaccounts, the number of Annuity Units per
payment attributable to a Subaccount to which the transfer is made is equal to
a. multiplied by b. divided by c., where:
a. is the number of Annuity Units per payment in the Subaccount from which the
transfer is being made;
b. is the Annuity Unit value for the Subaccount from which the transfer is
being made; and
c. is the Annuity Unit value for the Subaccount to which the transfer is being
made.
Conversion from a Fixed Annuity Payment
During the Annuity Period, You may convert Fixed Annuity payments to Variable
Annuity payments subject to the following:
1. You must send Us written notice in a form satisfactory to Us.
2. At least $30,000 of annuity reserve value must be transferred from Our
General Account, unless the transfer will eliminate the annuity reserve
value.
3. At least $30,000 of annuity reserve value must remain in Our General
Account after a transfer, unless the transfer will eliminate the annuity
reserve value.
4. Conversions from a Fixed Annuity payment are available only on an
anniversary of the Annuity Date.
5. We must receive notice at least thirty (30) days prior to the anniversary.
We reserve the right at any time and without notice to any party to terminate,
suspend or modify these conversion privileges.
When a conversion is made from a Fixed Annuity payment to a Variable Annuity
payment, the number of Annuity Units per payment attributable to a Subaccount to
which the conversion is made is equal to a. divided by b. divided by c., where:
Page 14
ANNUITY PERIOD PROVISIONS (continued)
a. is the annuity reserve being transferred from Our General Account;
b. is the Annuity Unit value for the Subaccount to which the transfer is being
made; and
c. is the present value of $1.00 per payment period using the attained Age(s)
of the Annuitant(s) and any remaining payment that may be due at the time
of the transfer.
The Annuity reserve value equals the present value of the remaining Fixed
Annuity payments using the same interest and mortality basis used to calculate
the Fixed Annuity payments.
Money converted to a Variable Annuity payment will be applied under the same
Annuity option as originally selected.
Conversion to a Fixed Annuity Payment
During the Annuity Period, You may convert Variable Annuity payments to Fixed
Annuity payments subject to the following:
1. You must send Us written notice in a form satisfactory to Us.
2. At least $30,000 of Annuity Unit value must be transferred to Our General
Account from the Subaccounts.
3. At least $5,000 of Annuity Unit value must remain in a Subaccount after a
transfer, unless the transfer will eliminate Your interest in the
Subaccount.
4. Conversions to a Fixed Annuity payment are available only on an anniversary
of the Annuity Date.
5. We must receive notice at least thirty (30) days prior to the anniversary.
We reserve the right at any time and without notice to any party to terminate,
suspend or modify these conversion privileges.
When a conversion is made from a Variable Annuity payment to a Fixed Annuity
payment, the number of Annuity Units per payment attributable to a Subaccount
from which the conversion is made is the product of a. multiplied by b.
multiplied by x., where:
a. is the number of Annuity Units representing Your interest in such
Subaccount per Annuity payment;
b. is the Annuity Unit value for such Subaccount; and
c. is the present value of $1.00 per payment period using the attained Age(s)
of the Annuitant(s) and any remaining payment that may be due at the time
of the transfer.
Money converted to a Fixed Annuity payment will be applied under the same
Annuity option as originally selected.
Payment of Death Benefits During the Annuity Period
If an Annuitant dies after the Annuity Date, the death benefit, if any, will
depend on the Annuity option in effect.
If an Owner, who is not also an Annuitant, dies after the Annuity Date, the
following provisions apply:
1. If the Owner was the sole Owner, the remaining Annuity payments will be
payable to the beneficiary in accordance with the Annuity option in effect.
The beneficiary will become the Owner.
2. If the Contract has joint Owners, the Annuity payments will be payable to
the surviving joint Owner in accordance with the terms of the Annuity
option in effect. Upon the death of the surviving joint Owner, the
beneficiary becomes the Owner.
Page 15
Page 16
ANNUITY PERIOD PROVISIONS (continued)
Disbursement Upon Death of Annuitant: Under Options 1, 3 or 5
When the Annuitant or surviving joint Annuitant dies, We will automatically
continue any unpaid installments for the remainder of the certain period under
Option 1, Option 3 or Option 5 to the Owner. However, if You elect within 60
days of Our receipt of due proof of death, We will pay a commuted value of the
remaining payments of the certain period. In determining the commuted value, the
present value of the remaining payments in the certain period will be calculated
based on the applicable interest rate.
For a Fixed Annuity option the applicable interest rate is the greater of:
(a) the ten year treasury constant maturity plus 3%, and
(b) the rate used to determine the initial payment plus 2%.
For a Variable Annuity option the applicable interest rate is the assumed
investment rate plus 2%
The amount of each payment for purposes of determining the present value of any
variable installments will be determined by applying the Annuity Unit value next
determined following Our receipt of due proof of death.
Supplementary Agreement
A supplementary agreement will be issued to reflect payments that will be made
under an Annuity option.
Date of First Payment
Interest, under an Annuity option, will start to accrue on the effective date of
the supplementary agreement. The supplementary agreement will provide details on
the payments to be made.
Evidence of Age, Sex and Survival
We may require satisfactory evidence of the Age, sex and the continued survival
of any person on whose life the income is based.
Misstatement of Age or Sex
If the Age or sex of the Annuitant has been misstated, the amount payable under
the contract will be such as the Purchase Payments sent to Us would have
purchased at the correct Age or sex. Interest not to exceed 6% compounded each
year will be charged to any overpayment or credited to any underpayment against
future payments We may make under this contract.
ANNUITY OPTION TABLE
AMOUNT OF MONTHLY PAYMENT FOR EACH $1,000 OF VALUE APPLIED
Option One - Certain Period Annuity
Number of years selected 10
Monthly Payment 9.39
Options Two and Three - Life Annuity With Installments Guaranteed
Age of Male Monthly Payments Guaranteed Age of Female Monthly Payments Guaranteed
Annuitant Annuitant
None 120 None 120
55 4.00 3.96 55 3.71 3.70
56 4.08 4.04 56 3.78 3.76
57 4.17 4.12 57 3.86 3.83
58 4.26 4.21 58 3.93 3.91
59 4.36 4.30 59 4.02 3.99
60 4.46 4.40 60 4.10 4.07
61 4.57 4.50 61 4.20 4.16
62 4.69 4.60 62 4.29 4.25
63 4.81 4.71 63 4.40 4.35
64 4.95 4.83 64 4.51 4.45
65 5.09 4.95 65 4.63 4.56
66 5.24 5.08 66 4.75 4.68
67 5.41 5.22 67 4.89 4.80
68 5.58 5.36 68 5.03 4.93
69 5.76 5.50 69 5.19 5.06
70 5.96 5.65 70 5.36 5.21
71 6.17 5.81 71 5.54 5.36
72 6.39 5.97 72 5.73 5.52
73 6.62 6.13 73 5.94 5.69
74 6.88 6.30 74 6.17 5.86
75 7.14 6.47 75 6.41 6.04
76 7.43 6.65 76 6.68 6.23
77 7.73 6.83 77 6.96 6.42
78 8.06 7.01 78 7.26 6.62
79 8.41 7.18 79 7.59 6.82
80 8.79 7.36 80 7.95 7.02
81 9.19 7.54 81 8.34 7.23
82 9.62 7.71 82 8.76 7.43
83 10.08 7.88 83 9.21 7.62
84 10.57 8.04 84 9.71 7.81
85 11.10 8.20 85 10.24 8.00
Option Four-Joint and 100% Survivor Annuity
Age of Female Annuitant
Age of Male
Annuitant 55 60 65 70 75 80 85
55 3.38 3.53 3.67 3.77 3.86 3.91 3.95
60 3.48 3.68 3.88 4.06 4.20 4.30 4.37
65 3.56 3.81 4.08 4.35 4.59 4.77 4.91
70 3.62 3.92 4.26 4.63 4.99 5.32 5.57
75 3.65 3.99 4.39 4.87 5.39 5.90 6.34
80 3.68 4.03 4.49 5.05 5.73 6.46 7.18
85 3.69 4.06 4.55 5.18 5.99 6.96 8.01
Option Five-Joint and 100% Survivor Annuity with Installments Guaranteed for 10
years
Age of Female Annuitant
Age of Male
Annuitant 55 60 65 70 75 80 85
55 3.38 3.53 3.66 3.77 3.85 3.91 3.94
60 3.48 3.68 3.88 4.05 4.19 4.29 4.35
65 3.56 3.81 4.08 4.34 4.57 4.74 4.86
70 3.61 3.91 4.25 4.61 4.96 5.26 5.46
75 3.65 3.98 4.38 4.84 5.33 5.78 6.13
80 3.67 4.03 4.47 5.01 5.63 6.26 6.78
85 3.69 4.05 4.52 5.12 5.84 6.63 7.34
Rates for ages not shown above will be provided upon reques.
Page 17
FLEXIBLE PREMIUM MODIFIED GUARANTEED, FIXED AND VARIABLE DEFERRED ANNUITY
CONTRACT
NON-PARTICIPATING
BENEFITS, PAYMENTS AND VALUES PROVIDED BY THE CONTRACT, WHEN BASED ON THE
INVESTMENT EXPERIENCE OF THE SUBACCOUNTS, ARE VARIABLE AND ARE NOT GUARANTEED AS
TO DOLLAR AMOUNT. REFER TO THE VARIABLE ACCOUNT AND ANNUITY PERIOD PROVISIONS
FOR A DETERMINATION OF ANY VARIABLE BENEFITS.
BENEFITS, PAYMENTS AND VALUES PROVIDED BY THE CONTRACT, WHEN BASED ON GUARANTEE
PERIOD VALUES, MAY INCREASE OR DECREASE IN ACCORDANCE WITH THE MARKET VALUE
ADJUSTMENT FORMULA STATED IN THE CONTRACT SCHEDULE.
READ YOUR CONTRACT CAREFULLY
Federal Xxxxxx Life Assurance Company
0000 XxXxxxxx Xxxxxxx, Xxxxxxxxxx, Xxxxxxxx 00000-0000
